Nicholas Lawrence
Depression is a Sustainability Problem


Everyone has seen the commercials on TV for Prozac or Zoloft. You know, that cute little bouncing ball that wanders around in sadness. Then the commercial turns from grayscale to being full of bright colors. The music turns cheerful. However the optimism of depression ads doesn’t reflect reality. Depression is a very serious problem facing the western world, and not just in terms of mental health, but sustainability. However, the way our culture functions serves to blind us to the full effects of depression. It’s not just some mental disorder that makes people sad; it’s much more than that. In many ways, depression is a symptom of deeper underlying flaw of western life.

Instances of depression are rising. Depression is the number one psychological disorder in the western world. Ten times more people suffer from major episodes of depression than in 1945 [depression]. Even more revealing is the correlation between a country’s affluence and their rates of depression. In general, wealthier nations have higher rates of depression. The US itself came in at 19.2% lifetime rate of depression, right behind France at 21% [2]. Only the year before the US had an 8.3% lifetime rate of depression [2]. And there are no signs this problem is going to get any better. The World Health Organization predicts by 2020 that depression will be the second largest global health burden [3]. But what is accounting for this increase? It’s not just more people talking to their doctors, although that could account for some of the increase. Depression is strongly linked to social conditions [2]. Of course it must be kept in mind there are existing disorders such as schizophrenia and bipolarism that are linked genetically that cause depression. But these make up only a fraction of depression cases. Thus it can be concluded that the social conditions of wealthy nations causes the majority of cases of depression. The disease of affluence is the name given to disease and health conditions thought to be linked to the wealth of a society [4]. Diabetes, heart disease, alcoholism, obesity, cancer and depression are all health conditions referred to by this term. And many of these conditions are linked [4]. For example obesity can cause depression or vice versa.

So what is about western society that causes social conditions to be conducive towards depression? It is the stress and burden placed upon the individual in western culture and the link between material things and happiness. There is a correlation between income and happiness, but to a certain extent. Living in poverty, struggling to make ends meet, or the threat of having your house repossessed can play havoc with your overall happiness. Yet once all these basic securities are met, there is no guarantee more wealth will bring happiness. Yet a large part of western culture is focused on happiness being some attainable goal met through money. Nowhere is this linkage more evident than in commercial ads. Almost every ad nowadays links their product to being the key to your happiness. Frustrated with your sex life? Just buy axe body spray. Tired of not being with the cool crowd? A new iPhone will change your life. And what is happiness? Humanity’s definition of happiness isn’t some constant ideal that has been handed down through the ages [5]. The idea of happiness being attainable via some action is a recent idea. And even more recent is the idea that a person should be happy and to not be implies fault in the system or the person themselves. In the time of the Greeks happiness = luck. In the time of Aristotle happiness = virtue [5]. Then fast forward to the renaissance, happiness = pleasure [5]. Then if you take a look today we’re still very much equating happiness to pleasure, physical or mental. What makes this pairing dangerous is the fact that our brains are wired to not feel happiness for very long. Research suggests that there are hedonic set points that are brains return to after a good or bad event [5 & 6]. A 1978 study between paraplegics, lottery winners and average day people found no significant difference in levels of happiness [6].

So humanities view of happiness hasn’t been constant. One can argue that we don’t even know what happiness is, we just know that we don’t have it. And our western society today however, attempts to answer that question of happiness through economic status and personal ownership. And yet when we buy something to makes us more happy or sexy and the excitement wears off, the model our culture runs on fails. And that is what prompts us to continue the cycle again. However, multiple failures in a row and we start to blame the system or even ourselves. We think happiness is a right and because we can’t obtain it we are a failure. And this is where depression sets in.

It should also be mentioned that the responsibilities upon the individual in western society also contributes to depression. In the US the ideal of individual pulling themselves up by their bootstraps, working their way out of poverty is constantly paraded around. You’re responsible for your own welfare. Go to school, work hard, get good grades, go to college, make money, pay off your loans, and change the world. Failing at any of these steps is your fault. This is the path of the ideal life and straying from it will result a broken life. And paired with this is the myriad of choices we face at each of these steps. At least in the US freedom can be equated with happiness and freedom is also equated with making any choice you want to. So you think being able to have a plethora of choices to choose from should make you happy. Well it turns out this isn’t the case. A study featured in Scientific American found a positive correlation between maximizers (people who sought to make the best possible choice) and depression risk [7]. When we make a decision and the outcome doesn’t achieve our expectations, we blame ourselves. We then think “I should’ve done X instead of Y”. Thus with new choices we fear failure and thus investigate all the options as best we can to an exhaustive end. Trivial details become more and more important and the conclusion that one can’t do anything right becomes a large detriment to your happiness [7]. And with today’s emphasis on personal choice and freedom, we’re all expected to navigate the maze of choices to find the best one for ourselves. Failure to do so is a failure of ourselves. A perfect example is the choice face by high school students of which college to go to. Many hold the ideal that the perfect college is out there waiting for them so they go through an agonizing search to find it. They try to predict how happy they’ll be at each college; a prediction they can’t make with any accuracy. And if they find the college they’ve enrolled in to not live up to their expectations, they have failed and derailed their life from the track to success and happiness.
It is western ideals that are responsible for the increase in depression that we’re facing today. The strive for wealth ultimately invites western ideals. Thus you have this link between wealth and depression rates in countries. But how does this tie into sustainability? Well for one depression is symptom of consumer orientated societies. Consumerism is not sustainable and if a society were to shift its ideals away from consuming there would be a corresponding decrease in depression. Thus having depression implies being unsustainable. This focus of material wealth being happiness encourages overconsumption and continuation of a faulty reward system. Secondly, depression affects a sizeable majority of people, 21 million people annually in the US [8]. People struggling with depression can’t be bothered with the issues of sustainability. They’re having enough trouble just going through the basics of their day, how are they suppose to further inconvenience their lives in the name of sustainability? They have only an individual view of themselves and their problems as compared to the group view needed to understand sustainability and the problems society faces.

There is one last major component of depression that affects sustainability. As stated before there has been a dramatic increase in rates of depression. This can be paired with increase in the antidepressant drug market. In 2004 global sales exceeded $15 billion. The US alone accounts for 71% of antidepressant sales [3]. The three largest drug revenues are for Effexor, Cymbalta and Prozac [9]. It would be safe to say that we are making and consuming large quantities of these drugs. However, the life of these drugs doesn’t end once we swallow them. Life continues on down the drain and into streams and watersheds. Yes, there very well could be antidepressants in the tap water you drink. Multiple studies have found antidepressants along with other pharmaceutical drugs in varied water sources. A study by the United States Geological Survey sampled 100 different sites across the US [10]. Detected containments consisted of caffeine, which was the highest-volume pollutant, codeine, cholesterol-lowering agents, anti-depressants, and Premarin, an estrogen replacement drug [10]. USGS also found in a stream in Texas the following antidepressants: Cymbalta, fluoxetine, fluvoxamine, norfluoxetine (a metabolite of fluoxetine), norsertraline (a metabolite of sertraline), paroxetine, sertraline, and Effexor [11]. Clearly antidepressant contamination is only part of the larger problem of pharmaceutical drug continuation. It should be noted that the levels of antidepressants detected were all trace amounts. Yet we don’t know the risk of long term exposure to trace amounts of chemicals. Neither do we know the synergistic effects of multiple drugs. Who knows how all those antidepressants found in that Texas stream work together? And some preliminary studies have shown that small amounts of antidepressants can adversely affect wildlife. A study done by the University of Portsmouth found the exposing shrimp to fluoxetine caused them to engage in suicidal behavior [12]. Shrimp associate light with predators such as fishermen and birds. However when exposed to fluoxetine, instead of normally avoiding light sources they were five times more likely to swim to light sources [12]. The levels of fluoxetine the shrimp were exposed to are the same levels that humans excrete into waste water [12]. In 2004 the FDA warned

“Neonates exposed to Effexor, other SNRIs (serotonin and norepinephrine reuptake inhibitors), or SSRIs (selective serotonin reuptake inhibitors), late in the third trimester of pregnancy have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding." [13]
Antidepressants are also thought to be endangering mussels in North America where about 70% of mussel species are extinct, endangered or declining [13]. CNN also reported in 2003 that antidepressants are adversely affecting fish and frogs [13].

Very clearly antidepressants are getting into our water stream and preliminary studies only spell danger. Antidepressants are drugs designed to affect brain chemistry. It’s not hard to see how this could be dangerous to us and the environment. Most importantly I hope this illustrates that depression is a major sustainability problem on two fronts. Not only is depression a symptom of the flaws of western culture but our attempts to treat it are damaging the environment. The way we view happiness isn’t sustainable. This is a problem our wealth can’t fix. And our attempts to treat the problem only worsen the sustainability of our society.

How can we fix this problem? There is no easy solution. The logical method would be to get rid of the source of the problem. But this requires a shift in western philosophy and ideals and redefining the culture of America. People must be educated that despite how alluring those TV ads are, material goods aren’t the sole way to happiness. A shift must be made away from the high consumption rates of the west. However doing this is extremely difficult and tricky. Changing these ideals will take a long time. Thus in the meantime, efforts must be made to stop antidepressant pollution. Waste water treatment plants should be designed to catch these pollutants. Also users of large quantities of these drugs such as hospital and pharmaceutical plants must be held responsible for the waste they discharge. Hopefully this will help the stem the infiltration of antidepressants into our water supplies. Higher depression rates can be seen as the price we pay for our western ideals. And once we can successfully treat depression, we can then concentrate our full energy to the sustainability of our western ideals.

Bibliography
  1. Senior, Jennifer. "Some Dark Thoughts on Happiness." New York: News and Features. New York Media, 09 July 2006. Web. 6 Nov 2011. http://nymag.com/news/features/17573/index2.html
  2. McMillen, Matt. "Richer Countries Have Higher Depression Rates." WebMD. WebMD, 26 jul 2011. Web. 6 Nov 2011. http://www.webmd.com/depression/news/20110726/richer-countries-have-higher-depression-rates
  3. "Impact of Generics on Antidepressant Market." Research and Markets. Decision Resources, Dec 2005. Web. 6 Nov 2011. http://www.researchandmarkets.com/reports/314820/impact_of_generics_on_the_antidepressant_market
  4. "Diseases of Affluence." Wikipedia. Wikimedia Foundation, 27 Jun 2011. Web. 6 Nov 2011. http://en.wikipedia.org/wiki/Diseases_of_affluence

  1. Jim Holt
Holt, Jim. "Happiness: A History." The New York Times. The New York Times, 12 Feb 2006. Web. 6 Nov 2011. http://www.nytimes.com/2006/02/12/books/review/12holt.html?pagewanted=1&adxnnlx=1312227074-KEJuetSpr4ILWs1/PL5rBQ

Jim Holt writes for the New Yorker, The New York Times and several other magazines. Often writes about philosophy and scientific subjects. He’s written several books such as Stop Me If You've Heard This: A History and Philosophy of Jokes and Why Does the World Exist?: An Existential Detective Story.

In this article for the New York Times Holt is reviewing Happiness: A History by Darrin M. McMahon. In his article he sums up the point of McMahon’s book. McMahon in his book argues that humanities view of happiness has changed over time and doesn’t have some universally accepted meaning.

Holt starts off by surmising the basic timeline of the definition of happiness over the ages. This provides an easy and quick way to see the sort of changes McMahon talks about in his book. Then Holt goes on to describe each stage of happiness in more detail. He talks of how Aristotle and Cierco equated happiness with virtue. And of how Christianity brought a sensual element into the definition of happiness in the Middle Ages. Lastly he moves onto talking about how happiness relates to society today.

“Happiness= Luck (Homeric), Happiness=Virtue (classical), Happiness=Heaven (medieval), Happiness=Pleasure (Enlightenment) and Happiness=A Warm Puppy (contemporary). Does that look like progress?”

“Everyone wants to be happy, but no one can say with much precision or assurance what happiness is.”

“McMahon is quite concerned, however, with what is sometimes called the paradox of happiness: the harder you endeavor to catch it, the more elusive it proves.”

The first quote from section 5 I outline in my paper to show how happiness has changed over time. I use this to explain the intangibleness of happiness and how our current model of what happiness isn’t intrinsic and thus can be wrong. This is important for this leads into that idea that if our idea of happiness is changeable and we also have such high depression rates, perhaps our viewpoint is wrong.

I use nearly all of the information in the first quote from section 5. I also use the idea of happiness as a set point that we snap back to. This idea I found from two separate sources so the appearance of it again on this articles second page helps to strengthen its validity.

  1. Senior, Jennifer. "Some Dark Thoughts on Happiness." New York: News and Features. New York Media, 09 July 2006. Web. 6 Nov 2011. http://nymag.com/news/features/17573/index2.html

  1. Barry Schwartz
Schwartz, Barry. "The Tyranny of Choice." Biopsychiatry. Scientific American, Dec 2004. Web. 6 Nov 2011. http://biopsychiatry.com/happiness/choice.html

Barry Schwartz is the Dorwin Cartwright Professor of Social Theory at Swarthmore. He has a B.A from New York University and a Ph.D. from University of Pennsylvania. He has written numerous books such as The Paradox of choice, The Battle for Human Nature: Science, Morality and Modern Life and The Costs of Living: How Market Freedom Erodes the Best Things in Life. He publishes editorials frequently in the New York Times and has published articles in Scientific American. He has also given several TED Talks.

The main topic of the text is how having more choices doesn’t increase happiness but rather hinders it. Having too much choice is bad for our happiness.

Schwartz first in his article describes the layout for his research which bears many similarities to my own. He states that increased choices and wealth has been paired with a decrease in happiness in most affluent countries. He then attempts to explain that why having increased choice and personal freedom doesn’t increase our happiness. Secondly he then begins to describe the data collection he did for his studies. He then defines his own terms: satisfiers and maximizers. Satisfiers concentrate on making a good enough choice while maximizers concentrate on making the best possible choice. Next he shows multiple statistical correlations between maximizers and satisfiers and their levels of happiness. Thirdly he presents reasoning for these correlations he has found. Maximizers experience more regret, are generally unhappier than satisfiers and have higher chance of depression.

” We think that worry over future regret is a major reason that individuals become maximizers. The only way to be sure you will not regret a decision is by making the best possible one.”

“As one commentator put it, "Children feel the pressure ... to be sure they don't slide back. Everything's about going forward.... Falling back is the American nightmare."”

“If the experience of disappointment is relentless, if virtually every choice you make fails to live up to expectations and aspirations, and if you consistently take personal responsibility for the disappointments, then the trivial looms larger and larger, and the conclusion that you cannot do anything right becomes devastating.”

This source is actually very crucial to my paper for I use the same reasoning as Barry Schwartz to link western culture and ideals to depression. I also expand upon Schwartz’s ideas by focusing on how consumerism promotes depression through the tyranny of choice.

I outline the same reasoning followed in the last quote from section 5. This quote is important for I use it to link consumerism with depression. I also use the second quote from section 5 to support my idea that individuality and pressure on the individual in western countries supports depression.

  1. "Ranking America's Mental Health: An Analysis of Depression Across the States." MHA. N.p., 2005. Web. 6 Nov 2011. http://www.nmha.org/go/state-ranking
  2. "Antidepressant Drug Market." Wikinvest. Etrade, 2009. Web. 6 Nov 2011. http://www.wikinvest.com/concept/Antidepressant_Drug_Market
  3. "Pharmaceuticals In Our Water Supplies." The University of Arizona. N.p., n.d. Web. 6 Nov 2011. http://ag.arizona.edu/azwater/awr/july00/feature1.htm
  4. "Measuring Antidepressants, Fungicides, and Insecticides in the Environment ." USGS. N.p., 27 Mar 2009. Web. 6 Nov 2011. http://toxics.usgs.gov/highlights/measuring_contaminants.html

  1. Alasdair Wilkins
Wilkins, Alasdair. "Antidepressants in the water are making shrimp suicidal." i09. N.p., 12 Jul 2010. Web. 6 Nov 2011. http://io9.com/5584563/antidepressants-in-the-water-are-making-shrimp-suicidal

Alsdair Wilkins is a reporter for i09, an online news source. He has written many movie reviews and writes scientific articles. He has a degree in History & Science and Archeology.

The article is a review of an scientific study done by Alex Ford, a Marine Biologist at the University of Portsmouth. In this study evidence is found that the antidepressant fluoxetine increases the suicidal tendencies of shrimp.

The article is somewhat short but he starts out by stating the main results of the study: exposure to fluoxetine causes shrimp to radically alter their behavior. He then quotes Alex Ford to explain the seriousness of fluoxetine’s effect on behavior. He then describes the impetus for Alex Ford’s study of the effect on fluoxetine on shrimp.

“Exposure to antidepressants makes shrimp five times more likely to place themselves in life-threatening situations…”

“Ford exposed some shrimp to the same amount of fluoxetine that humans excrete into the waste water that gets carried out to sea. He found that even this seemingly small amount was enough to trigger this major behavioral change in the shrimp.”

“Prescriptions for antidepressants have skyrocketed in recent years, but this is one of the very first attempts to figure out what ecological impact all that pharmaceutical sewage could have.”

This source provides support for the other half of my matrix problem: the effects of antidepressant pollution on the environment. This study done by Alex Ford is very compelling for it shows that antidepressant exposure has a clearly negative effect on the shrimp. This could unbalance the ecosystem and cause disproportionate damage. This article helps tie in sustainability to depression in an unseen way.

I state the statistic in the first quote from section 5. I also use the second quote from section 5 to support the possible dangers of long term, low dose chemical pollution. Other sources I came across listed trace amounts of pollutants. This article however links trace amounts of chemicals to negative effects in an organism.

  1. Mergel, Maria. "Antidepressants in Our Water." Toxipedia. N.p., 06 Sep 2010. Web. 6 Nov 2011. http://toxipedia.org/display/toxipedia/Antidepressants+in+Our+Water